How can I find out the cost of a medical procedure before I get it?

Understanding the cost of a medical procedure beforehand can help you plan and avoid unexpected bills. To get an estimate, you can contact your insurance provider directly, as they can explain your benefits and covered amounts. Additionally, for specific fee schedules based on CPT codes and your location, you can use services like Payerprice. They offer a fee schedule lookup tool that can provide more detailed information for various medical services, helping you to research potential costs.

What is a CPT code and why is it important for understanding healthcare costs?

CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit alphanumeric codes used by medical professionals to report medical, surgical, and diagnostic services to entities such as physicians, hospitals, and outpatient facilities. These codes are crucial for understanding healthcare costs because they precisely define the service rendered, allowing for accurate billing and reimbursement. When you know the CPT code for a procedure, you can more accurately search for its cost and compare prices, for instance, by using tools like Payerprice.

Where can I look up the fees for specific medical services based on my location?

To look up fees for specific medical services based on CPT codes and your location, it's best to use dedicated tools designed for healthcare cost transparency. Payerprice provides a fee schedule lookup tool where you can input the CPT code and your specific location to find relevant pricing information. This can give you a clearer picture of what you might expect to pay or what your insurance might cover for a particular service in your area.

What's the difference between a negotiated rate and the listed price for a medical service?

The 'listed price,' often called the charge master price or sticker price, is the full amount a healthcare provider charges for a service before any discounts or insurance adjustments. This price is rarely what patients or insurers actually pay. A 'negotiated rate,' on the other hand, is the discounted price that an insurance company has agreed upon with a healthcare provider for a specific service. If you have insurance, you will typically pay a portion of this negotiated rate (e.g., through copay, deductible, or coinsurance), rather than the full listed price. Tools like Payerprice often help you find data closer to these negotiated rates or typical reimbursement amounts, providing a more realistic cost estimate.

CPT 70486 Fee Schedule

Last Verified: September 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Ct Scan Of Face And Jaw, A Ct Scanner Circles The Head Taking X-Rays Of The Face And Jaw And Assembles Them Into A 3-D Image. Dye Might Be Used To Highlight Areas On The Images.

Key Fact	Detail
Service Type	Radiology Procedures Diagnostic Radiology (Diagnostic Imaging) Procedures
Common Place of Service	23 - Emergency Room 11 - Office
Common Modifiers	None 26 - Professional component TC - Technical component
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 70486
Medicaid Fee Schedule	View Medicaid rates for 70486

National average reimbursement for CPT 70486 by major payers:

$172.59

$206.00

$247.42

$241.65

Compare published rates across providers.

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CPT 70486

5 of 25 sample ratesHigher to lower in this preview

Zahir Javeri
TXDiagnostic Radiology PhysicianNPI 1093925976Tax ID 76-0386391
$882.80Published rate
Robert Morrison
TXDiagnostic Radiology PhysicianNPI 1922291863Tax ID 76-0453250
$233.19Published rate
Chand Mathur
TXDiagnostic Radiology PhysicianNPI 1710904370Tax ID 76-0635401
$141.47Published rate
Lance Williams
TXDiagnostic Radiology PhysicianNPI 1194773549Tax ID 77-0078751
$80.51Published rate
John Bliznak
TXDiagnostic Radiology PhysicianNPI 1942488531Tax ID 92-3251632
$44.02Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 70486 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes

The CPT 70486 code is part of the Radiology Procedures services used for Diagnostic Radiology (Diagnostic Imaging) Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 70486 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
70481-CPT	Moderate	Ct Scan Of Eye Socket Or Ear, A Ct Scanner Circles The Head Taking X-Rays Of The Eye Socket Or Ear And Assembles Them Into A 3-D Image. Dye (Contrast) May Be Used To Make The Area Easier To See.
70486-CPT	Low	Ct Scan Of Face And Jaw, A Ct Scanner Circles The Head Taking X-Rays Of The Face And Jaw And Assembles Them Into A 3-D Image. Dye Might Be Used To Highlight Areas On The Images.
70487-CPT	Low	Ct Scan Of Face And Jaw, A Ct Scanner Circles The Head Taking X-Rays Of The Face And Jaw And Assembles Them Into A 3-D Image. Dye Might Be Used To Highlight Areas On The Images.
70488-CPT	Moderate	Ct Scan Of Face And Jaw, A Ct Scanner Circles The Head Taking X-Rays Of The Face And Jaw And Assembles Them Into A 3-D Image. Dye Might Be Used To Highlight Areas On The Images.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 70486. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 70486 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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CPT 70486 Fee Schedule

Zahir Javeri

Robert Morrison

Chand Mathur

Lance Williams

John Bliznak